Lipomas are the most common nonepithelial tumors of the colon, and rank third in frequency among benign colonic tumors after hyperplastic and adenomatous polyps [1 2 3
A 47-year-old woman presented with intermittent, colicky abdominal pain. Physical examination showed no specific finding except for pale conjunctiva. Laboratory investigation revealed iron-deficiency anemia. The fecal occult blood test was positive. Double contrast colon series showed an irregular lobulated mass, measuring 5 cm in diameter and located in the hepatic flexure ([Figure 1 Figure 2 Figure 3
Figure 1 Double contrast colon series showed an irregular lobulated mass measuring 5 cm in diameter, located in the hepatic flexure.
Figure 2 Colonoscopy revealed a polypoid mass with an irregular lobulated margin, and tan-pink ulcerated necrotic surface that mimicked a malignant tumor.
Figure 3 Abdominal computed tomography showed an ill-defined fat-containing soft-tissue mass, which acted as a leading point of intussusception (a , arrow). The wall of the colon near the mass was thickened with rings of intussusception (b , arrow). There was no lymphadenopathy.
The gross appearance of the lesion was that of a polypoid hard mass measuring 5 × 4 × 4 cm, with an ulcerated necrotic surface and located at the distal ascending colon ([Figure 4 Figure 5
Figure 4 Resected specimen of the colon showed a polypoid hard mass measuring 5 × 4 × 4 cm, with an ulcerated necrotic surface, located at the distal ascending colon.
Figure 5 Pathologic findings revealed mucosal ulceration with inflammation and fibrosis. The submucosal mass was composed of mature adipose tissue. (Hematoxylin and eosin, original magnification × 100).
Large colonic lipomas (> 2 cm) can present as abdominal pain from obstruction or intussusception, and bleeding or chronic anemia could occur when mucosa overlying the lipoma is ulcerated [4 5
Endoscopy_UCTN_Code_CCL_1AD_2AB
Endoscopy_UCTN_Code_CCL_1AD_2AC
